Article Abstract

Essential processes of successful trauma systems: template for analysis of trauma systems

Authors: James S. Gregory, Charles Walker, Katelyn Young, Anna Ralchenko


Background: Several papers have attempted to define one unified best trauma system. Our working hypothesis was that analysis of large systems many of which have similar elements was likely to produce inconclusive results, if the goal was to identify an ideal or model trauma system. Our premise was that any system with the similar processes would likely yield similar outcomes. We reviewed the literature with an eye towards identifying the common processes present within successful trauma systems.
Methods: A systematic literature search was performed using the United States National Library of Medicine’s PubMed database in October 2017. 8,459 articles were screened and full-text original research studies were included if they reported trauma patient outcomes in association with the implementation of trauma training or trauma system infrastructure. Articles meeting these criteria included case-control and cohort studies, which incorporated prospective and retrospective study designs. There were 51 articles that met our criterion for inclusion.
Results: Twenty-seven focused on different elements of trauma systems and 24 concentrated on training both individual and team. Nine processes were identified with significant interrelatedness between them.
Conclusions: Previous papers were seen to confuse outcomes of these processes with the effect of the trauma system. We suggest that further research be careful to not mix system analysis with process analysis and be cognizant that components of processes. We suggest that trauma systems be analyzed based on the effect of “Right Care to the Right Place at the Right time”.